A directory of the General Medical Council, United Kingdom, released recently declared all graduates who completed their studies in nine Nigerian medical schools after December 2010 ineligible for licensing to practise medicine in the UK. The decision, GMC explained, only applied to students who graduated from those medical schools after the Medical and Dental Council of Nigeria suspended their accreditation in April this year.In reaching the decision in 2010, the MDCN stated that the council wishes to reassert that the issue at stake is the unsatisfactory and inadequate training of students who shall be licensed as doctors to treat the citizens of this country based on the visitation panel report to MDCN. It however said it would be ready to pay accreditation visits to the affected schools within the next 12 months, on an appropriate date, if the university authorities requested such a visitation.Though the deficiency that led to the de-accreditation in eight of the nine schools has since been rectified, the anxiety raised on the quality of Nigerian medical graduates should not be ignored. In accordance with the Medical and Dental Practitioners Decree No. 23 of 1988, one of the statutory functions of the MDCN is to approve the institutions at which courses of training are to be given for persons seeking to become members of the medical profession as well as the courses of instruction prescribed and the qualifications to be granted by such institutions. The MDCN also has the responsibility of supervising the nature of the instruction and the examinations leading to the qualifications to be granted. Similarly, all doctors who work in the UK are required to be registered with the GMC and to comply with the standards of good practice set out in the core GMC guidance, Good Medical Practice.The colleges of medicine/health sciences of Nnamdi Azikiwe University, University of Benin, University of Jos, University of Nigeria, University of Port Harcourt, Ambrose Ali University, Ebonyi State University, Igbinedion University, and Ladoke Akintola University of Technology were listed as ill-equipped to provide standard education in medicine. That conclusion, foreshadowed by the de-accreditation in 2010 of UNIBENs College of Medicine, Igbinedion University College of Health Sciences, and University of Abuja College of Medicine, among others, by the MDCN, calls into question the quality of manpower available in Nigeria for health care delivery. Neither the government nor the authorities of the blacklisted institutions can pretend that such graduates adjudged unfit for registration as medical practitioners in Britain and elsewhere, could be relied upon as health care givers in Nigeria. Besides, the probability is high, in this era of gross under-funding of education, that other medical schools are in equally deplorable states and their graduates unfit for medical practice. Dr. Omede Idris, who is the President of the Nigerian Medical Association and MDCN member, says the problem is caused by over admission, which, he says, overwhelms the facilities available at the medical schools and the trainers.Without exception, the medical schools are grossly under-equipped in terms of teaching personnel, equipment, teaching/research facilities, and funds for running costs. These are requirements that could be easily met if the necessary will exists on the part of the federal and state governments as well as the proprietors of private universities. MDCN has clearly identified what is required in each case. Proprietors have to mobilise the needed resources and assist the authorities to ensure a conducive learning environment, free of incessant work stoppages by personnel.The demands of the health sectorits training institutions and hospitals/pharmaciesare of particular importance to every country. The quality of human resourcesmedical practitioners, nurses, medical laboratory scientists and pharmacistsas well as equipment/facilities in that sector is vital for the maintenance of a healthy citizenry, a key indicator of social development.Adequacy of resource allocation should translate into improved access to quality health care. Nigerias record of one medical doctor to 6,000 persons is scandalous, to say the least, when juxtaposed with the World Health Organisations prescribed ratio of one (medical doctor) to 1,000 persons. Cuba has a doctor population ratio of one to 165, while South Korea has one to 337. To address Nigerias deficits, the authorities should target both quantity (in relation to the prescribed ratio) and quality as highlighted by both MDCN and Britains GMC.Through the effectiveness of the MDCN, unqualified persons would, hopefully, be filtered out of the health care delivery chain. But the immediate challenge before governments and proprietors of medical schools is to expeditiously address the deficiencies repeatedly highlighted by the MDCN, as contained, especially, in its Re-Accreditation Visitation Report on each medical training institution, released in 2010.Beyond the challenges thrown up by the blacklisting, there is a need for the MDCN to urgently take interest in the quality of services provided by registered practitioners.
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